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Treatments and drugs
By Mayo Clinic staffPeople with schizoaffective disorder generally respond best to a combination of medications and counseling. Treatment varies depending on the type and severity of symptoms, and whether the disorder is depressive-type or bipolar-type.
In general, doctors prescribe medications to relieve psychotic symptoms, stabilize mood and treat depression. The only medication approved by the Food and Drug Administration (FDA) for the treatment of schizoaffective disorder is the antipsychotic drug paliperidone (Invega). However, a number of medications approved for the treatment of other mental health conditions also may be helpful for schizoaffective disorder.
In addition, psychotherapy can help normalize thought patterns, teach social skills and reduce social isolation.
Medications used to treat schizoaffective disorder may include:
- Antipsychotics. Also called neuroleptics, doctors prescribe these medications to treat psychotic symptoms, such as delusions, paranoia and hallucinations. In addition to paliperidone (Invega), other antipsychotic medications that may be prescribed include clozapine (Clozaril, FazaClo), risperidone (Risperdal) and olanzapine (Zyprexa).
- Mood-stabilizing medications. When the schizoaffective disorder is bipolar-type, mood stabilizers can level out the highs and lows of bipolar disorder, also known as manic depression. People with bipolar disorder have episodes of mania and depressed mood. Examples of mood stabilizers include lithium (Eskalith, Lithobid) and divalproex (Depakote). Anticonvulsants such as carbamazepine (Carbatrol, Tegretol, others) and valproate (Depacon) also may be used for their mood-stabilizing properties.
- Antidepressants. When depression is the underlying mood disorder, antidepressants can treat feelings of sadness, hopelessness, or difficulty with sleep and concentration. Common medications include citalopram (Celexa), fluoxetine (Prozac) and escitalopram (Lexapro).
Nonmedication therapy may include:
- Psychotherapy and counseling. Building a trusting relationship in therapy can help people with schizoaffective disorder better understand their condition and feel hopeful about their future. Effective sessions focus on real-life plans, problems and relationships. New skills and behaviors specific to settings such as the home or workplace also may be introduced.
- Family or group therapy. Treatment can be more effective when people with schizoaffective disorder are able to discuss their real-life problems with others. Supportive group settings can also help decrease social isolation and provide a reality check during periods of psychosis.
In general, people with schizoaffective disorder have a better prognosis than people with schizophrenia, but not as good as people with mood disorders only. Long-term treatment is necessary, and the prognosis varies from person to person.
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- Schizoaffective disorder. National Alliance on Mental Illness. http://www.nami.org/Content/ContentGroups/Helpline1/Schizoaffective_Disorder.htm. Accessed Oct. 14, 2010.
- Gejman PV, et al. The role of genetics in the etiology of schizophrenia. Psychiatric Clinics of North America. 2010;33:35.
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- Jibson MD. Schizophrenia: Diagnostic evaluation and treatment. http://www.uptodate.com/home/index.html. Accessed Oct. 14, 2010.
- Schizoaffective disorder. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec15/ch202/ch202d.html. Accessed Oct. 14, 2010.
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